Despite the growth of a variety of alternatives to the neighborhood high school, most students in big-city school systems still attend large comprehensive high schools that serve a particular residential area. The authors contend that the extreme concentration of educational need at these schools is often overlooked by policymakers, school reform programs, and even district personnel. To illustrate the challenges facing neighborhood high schools, this article examines key academic characteristics of 9th-graders in Philadelphia during the 1999-2000 school year. The authors find that a large percentage of 9th graders at neighborhood high schools have been 9th graders for 2 or more years. Many of the 1st-time 9th graders either are over-age, are 2 or more years below grade level in reading and math, or had weak attendance in 8th grade. These data suggest that large and sustained investments of human and financial capital are desperately needed in the many neighborhood schools that serve primarily, and often almost exclusively, students with multiple risk factors for academic failure.